December 21, 2009

"So let me start out by stating the bottom line: If the national strategy is a plan to end AIDS, then it must include real strategies that end homelessness and housing instability for people living with HIV and those most at risk. Anything short of that is a plan to maintain the epidemic, not to bring it to an end.

"Now I know that some will argue that this statement overreaches. But the reality is that we have now poured billions of dollars into individual-level interventions when so much research points to the many socioeconomic drivers of the epidemic. Homelessness is one leading driver that is proved to be amenable to intervention and has been shown to have a direct, independent and powerful impact on both prevention and health outcomes.

"Very simply, prevention interventions that focus on changing the behavior of individuals are doomed to fail if we deny these individuals access to a proven, cost-effective prevention and health care intervention—a safe and secure place to live. The research—and there is a lot of it now—clearly shows that persons who lack stable housing are far more likely to become HIV infected, will have limited access to care once they are infected, and will live less healthy and shorter lives than persons just like them who are fortunate enough to have a home.

"Why is housing so critical? Because having a safe, secure place to live is fundamental to the basic activities of daily living. When one is homeless or facing housing instability, immediate survival must, by necessity, take priority over other activities and choices."